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New Treatments for Lung Cancer

Shaina McQuilkie | May 30, 2024
Health

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Lung cancer is the second most common cancer in both men and women and is the leading cause of cancer death in the United States. Estimates suggest that in 2024, there will be about 234,580 new cases of lung cancer and about 125,070 lung cancer deaths. While prognosis is generally poor for lung cancer patients, especially for advanced stages of the disease, in recent years, research breakthroughs have revolutionized the approach to the treatment of lung cancer, offering patients and their families renewed optimism and hope.

Symptoms of Lung Cancer

Signs and symptoms of lung cancer usually occur once the disease has progressed to more advanced stages, and may include:

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  • A new and persistent cough.
  • Coughing up blood.
  • Shortness of breath.
  • Unintentional weight loss.
  • Hoarseness.
  • Chest pain.
  • Bone pain.
  • Headache.

Advancements in the Early Detection of Lung Cancer

Significant strides have been made to identify lung cancer at its earliest stage, using several key approaches, including:

Low-dose CT scans: The National Lung Screening Trial (NLST) found that these scans decrease mortality risk in heavy smokers. Ongoing research aims to improve their predictive accuracy.
Blood and sputum markers: Researchers are fine-tuning tests to detect lung cancer using blood and sputum samples that detect abnormal cells and molecular markers to help guide early diagnosis.
Machine learning: Computer algorithms help identify lung cancer from CT scans. These artificial intelligence programs have impressive accuracy rates and can also detect genetic mutations.

Treatment for Lung Cancer

There are a variety of treatment options available for lung cancer including surgery, chemotherapy, radiation, targeted therapy and immunotherapy.

Early-Stage Lung Cancer Treatment

Early-stage lung cancer treatment may include:

Surgery: For early-stage non-small cell lung cancer (NSCLC), surgery is the standard approach to treatment with surgeons removing the affected lobe, or a portion of it that contains the tumor.
Targeted therapy: For early-stage NSCLC, Osimertinib (Tagrisso) is approved for adjuvant therapy (after surgery) in patients with specific EGFR gene mutations.
Immunotherapy: Atezolizumab (Tecentriq) and pembrolizumab (Keytruda) have been approved as adjuvant treatment following surgery and chemotherapy. Further, Nivolumab (Opdivo) is used in combination with chemotherapy before surgery as a neoadjuvant therapy.

Late-Stage Lung Cancer Treatment

New therapies, including immunotherapies and targeted therapies, are available for late-stage lung cancer.

Immunotherapies use the body’s immune system to fight cancer. Researchers continue to explore combinations of immunotherapies, with or without, chemotherapy. Immune checkpoint inhibitors are drugs that block the interaction between immune cell proteins and cancer cells. Approved immune checkpoint inhibitors for advanced lung cancer include:

  • Pembrolizumab (Keytruda).
  • Atezolizumab (Tecentriq).
  • Cemiplimab (Libtayo).
  • Durvalumab (Imfinzi).
  • Nivolumab (Opdivo).

Targeted therapies work by selectively attacking cancer cells while minimizing harm to healthy cells. In recent years there has been significant progress in the development of targeted therapies for advanced lung cancer, including:

Anaplastic Lymphoma Kinase (ALK) inhibitors

  • Approved treatments for NSCLC patients with ALK gene alterations include Ceritinib (Zykadia), brigatinib (Alunbrig) alectinib (Alecensa) and lorlatinib (Lorbrena).
  • These drugs target rearrangement in the ALK protein, which drives cancer growth.
  • These newer ALK inhibitors have an improved ability to cross the blood-brain barrier, which is crucial because progression to the brain is common in lung cancer patients with ALK alterations.

EGFR Inhibitors

  • Osimertinib (Tagrisso) is the most effective and widely used EGFR inhibitor. It can also be used as an adjuvant after surgery of NSCLC. Other EGFR inhibitors include afatinib (Gilotrif), dacomitinib (Vizimpro), erlotinib (Tarceva) and gefitinib (Iressa). Further, amivantamab (Rybrevant) is an approved targeted therapy in patients with mutations of Exon 20.
  • These drugs block the activity of epidermal growth factor receptor (EGFR), which is a protein associated with rapid lung cancer growth.

ROS1 Inhibitors

  • Approved treatments for patients with ROS1 alterations include Crizotinib (Xalkori) and entrectinib (Rozlytrek).
  • The ROS1 protein plays a role in cell signaling and growth. A small percentage of NSCLC patients have rearranged forms of the ROS1 gene.

BRAF Inhibitors

  • Approved treatment for patients with NSCLC with BRAF gene mutation includes a combination of dabrafenib (Tafinlar) and trametinib (Mekinist). Further, encorafenib (Braftovi) combined with binimetinib (Mektovi) has been approved for patients with metastatic NSCLC with a BRAF V600E mutation.
  • When there are certain changes in the B-Raf gene, NSCLC cells can grow and spread. BRAF inhibitors directly target the B-Raf protein, which plays a crucial role in cell signaling and growth.

Transforming Care

Treatment of lung cancer is rapidly evolving with exciting breakthroughs providing hope to patients and their families. Various therapies exist for early-stage lung cancer including surgery, radiation, chemotherapy, immunotherapy and targeted therapy. Newer immunotherapies and targeted therapies are providing better outcomes for patients with advanced lung cancer, helping to improve quality of life and survival. With advancements in research, the future of lung cancer treatment looks promising for providing further improvement in treatment outcomes.

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